Unprofessional conduct by nurses: A document analysis of disciplinary decisions

Background: A small minority of nurses are investigated when they fail to meet the required professional standards. Unprofessional conduct does not just affect the nurse but also patients, colleagues and managers. However, it has not been clearly defined.Objective: The objective was to identify unprofessional conduct by registered nurses by examining disciplinary decisions by a national regulator.Design: A retrospective document analysis.Data and research context: Disciplinary decisions delivered to 204 registered nurses by the Finnish national regulatory authority from 2007 to 2016. The data were analysed with quantitative statistics.Ethical consideration: The study received permission from the Finnish National Supervisory Authority for Welfare and Health and used confidential documents that were supplied on the basis of complete anonymity and confidentiality.Findings: The mean age of the registered nurses who were disciplined was 44 years and 81% were female. Two-thirds had worked for their employer for 5 years or less, 53% had two or more employers and 18% had a criminal history. All the decisions included a primary reason for why the nurses were investigated, but there were also 479 coexisting reasons. In most cases, unprofessional conduct was connected to substance abuse (96%). In addition, stealing of medicine, a decreased ability to work and neglect of nursing guidelines were reported.Discussion: We found that the nurses were investigated for unprofessional conduct for complex combinations of primary and coexisting reasons. Our study highlighted that more attention needs to be paid to the key markers for unprofessional conduct.Conclusion: Unprofessional conduct is a complex phenomenon that is connected to nurses' individual and working backgrounds and has an impact on their work performance. More research is needed to identify how nursing communities can detect, manage and limit the serious effects and consequences of unprofessional conduct.</p

Ethical issues identified in nurses´ interprofessional collaboration in clinical practice: a meta-synthesis

The aim of this study was to synthesize previous knowledge about ethics in nurses' interprofessional collaboration in clinical practice. Although healthcare professionals have common goals and shared values, ethical conflicts still arise during patient care. We carried out a meta-synthesis of peer-reviewed papers published in any language from 2013-2019, using both electronic searches, with the CINAHL, PubMed, Scopus, and SocINDEX databases, and manual searches. We identified 4,763 papers and selected six qualitative papers, and three theoretical papers, based on predetermined inclusion and exclusion criteria and quality appraisal. The studies came from the USA, Canada, Sweden, Australia, Botswana, and the Netherlands. We found that in ethics studies on nurses' interprofessional collaboration in clinical practice the focus has been on factors that affect how patients receive care. These factors were patients' wishes, whether they were told the truth about their condition, and how different professionals recognized and treated their pain. The focus in the papers we reviewed was on the roles of different professionals during the care process, including ethical conflicts with regard to their aims, commitment, and the balance of power among them and other professions. More research is needed to raise the visibility of how nurses and other professionals recognize, and evaluate, their professional and interprofessional ethics

Developing a Feasible and Credible Method for Analyzing Healthcare Documents as Written Data

Healthcare provides a rich, and constantly increasing, number of written documents, which are underutilized in research data for health and nursing sciences, but previous literature has only provided limited guidance on the process of document analysis. The aim of this paper is to provide a methodological framework for analyzing health care documents as written data, based on a systematic methodological review and the research team's experience of the method. Based on the results, the methods consist of seven phases: (i) identify the purpose, (ii) determine the document selection strategy, (iii) select or design an extraction matrix, (iv) carry out pilot testing, (v) collect and analyze the data, (vi) consider the credibility, and (vii) ethics of the study. The framework that has been developed can be used to carry out document analysis studies that are both feasible and credible